Attitudes towards FMG's

[harshanl]

Hi Everyone,
I'm a 5th year medic at Oxford, and am interested in doing a residency in the US when I qualify. From reading some of the threads on this forum, it seems that this is not a well trodden route. Is there anyone else out there who has/is interested in moving to the US after qualifying in the UK? Are UK graduates similarly disadvantaged to other FMG's in breaking into the US system?

Another question I have is to what extent one is disadvantaged as a FMG AFTER obtaining a residency. Are FMG's mistreated/exploited/abused compared to their US counterparts during the residency and afterwards (when applying for fellowships etc)? Or is everyone on an equal footing after getting past the residency application bottleneck? Do people get respected in most hospitals for the quality of thier practice as opposed to where they went to medschool?

I've been reading some of the residency reviews on scutwork.com, and most of the correspondents quote the number of FMG's on their program as if it were inversely proportional to the quality of the program (e.g. we have only x scum of the earth at our hospital). Is this representative of the general prevailing attitude towards FMG's?

So many questions, so few answers!
Any comments would be gratefully received.
Thanks,
Harshan

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[Docgeorge]

I think that the discrimination that is faced by FMG's is because of an assumed lack of quality in their training. I think though that because you will have graduated from Oxford, you will not have to face as many challenges in regards to finding a residency. The residents on this board could probabally give you a definative anwser.

 

[Andrew_Doan]

Originally posted by Docgeorge
I think that the discrimination that is faced by FMG's is because of an assumed lack of quality in their training. I think though that because you will have graduated from Oxford, you will not have to face as many challenges in regards to finding a residency. The residents on this board could probabally give you a definative anwser.

I agree with this.

 

[Future GI Guy]

I think you may be reading those scutwork reviews the wrong way.

It is common knowledge that, the more competitive a program is, the more selective it can be towards its residents.

There is an overwhelming bias in this country towards American Medical Graduates, simply because there is a greater financial incentive for the program to take graduates who can work without any of the visa issues associated with FMG's.

A more competitive program will, therefore, select only American graduates because it's easier on the program to put those graduates to work sooner, and without all the fussy paperwork. What's more, Medical Schools in this country are regulated, and the quality of training for these graduates (though same may argue this) is a reasonably stable, known entity.

It has nothing to do with "scum" or anything of the sort.

So when people say, "Our program has 1 FMG per year," they're essentially saying, "We have a moderately competitive program."

If someone said, "Our program only takes IVY League Graduates," I would probably think the competition there is overwhelming, not that they feel graduates of my medical school (in Missouri) are 'scum.'

That said, I have known some Foreign Medical Graduates (a very, very small minority) who were absolutely dangerous in the context of patient care, and that leaves a lasting impression on any program director. This is especially true if the FMG's were kicked out of the residency (which is the case in the examples I'm thinking of); I doubt that the program director will look twice at candidates from this same foreign medical college.

 

[harshanl]

Thanks for all the replies guys. I guess what I'm really interested in is whether FMG's run into any discrimmination issues AFTER getting into a residency.

A common view is that the US system is hard to break into, but once you do get in and prove yourself, people respect you for what you are as opposed to where you're from. It would be interesting to hear some anecdotal evidence in support of this in the form of FMG success stories.

Thanks,
Harshan

 

[ny skindoc]

It is my experience that once you "break in" you should have no problem.In most hospitals residents generally have no idea where the physicians they work with went to med school.How you are viewed has much more to do with how you conduct yourself,your work ethic and other variables.Once you are in practice your colleagues will evaluate you by your competence and personality factors.Most of the problem for IMGs is "breaking into" certain hospitals and specialties in the first place.The presence of many FMGs in a program is looked at negatively as it suggests the program has problems and is not sought after by US grads for one reason or another.Sometimes hospitals in geographically undesirable areas have trouble getting USMGs but otherwise are fine. Many prestigious programs have a number of highly qualified FMGs as residents.

 

[maxheadroom]

You should do well in the U.S. I've seen several European physicians in different practices in the U.S. One of the hallmark characteristics of Americans is an egalitarian sense of fair play. If you're intelligent, hard-working, and a team player, you'll be welcomed into American medicine. Good luck. Come join the fracas.

 

[Winged Scapula]

Its true...very few of us know where others went to medical school. However, I suspect you may have an accent that will give your status away. Do not fear my friend, as an Oxford education carries much more "ooh-aahh" factor than does say a US medical degree from Podunk U.

While there may always be *some* stigma from some uninformed colleagues, my guess is that the vast majority of your future colleages will judge you on your work ethic and not where you went to medical school (don't be suprised if they expect you to be a superstar, coming from Oxford and all!).

 

[southerndoc]

Originally posted by Kimberli Cox
Its true...very few of us know where others went to medical school. However, I suspect you may have an accent that will give your status away. Do not fear my friend, as an Oxford education carries much more "ooh-aahh" factor than does say a US medical degree from Podunk U.

Yea, at least people know where Guatalajara, the Caribbean, etc. are when you mention where you went to school. When I mention my medical school, people outside of Georgia always go "where the heck is that?"

 

[Ligament]

Coming from Oxford, you would be looked at very favorably by most programs. You would probably be ranked higher than most AMGs.

Plus, I assume you have a British accent, which automatically places you at "Genius" level in America.

You would place well I'm sure.

regards.!

 

[painres]

Lets not forget the language part of the equation here. I think that no one likes to work with a physician that they cant communicate with. If you can speak good english, this is a big plus, and as you are from the UK you probably speak better english than I do

 

[commymommy]

My husband (a German citizen who was born and raised there) went to med school in his native country. He did 3 years of residency in europe before we decided to move to the states. He took the USMLEs and has unbelievably good scores, especially considering that he took them in what was then a foreign language to him....he speaks english very well now.

He faced discrimination during residency but not fellowship. During residency, he was not "allowed" to moonlight...despite the fact that the had the highest scores of anyone there moonlighting....he was permitted, of course to take q3 call and work like a dog for the hospital, but FMGs were frowned upon in general.

I still have friends whose husbands are also physicians that look down on my husband's professional credentials with the motto "made in the USA is the only way". My dh's board scores, research record and excellent reviews mean nothing to these few.

So..it does exist...


kris

 

[anonymousEM]

I've seen most of the FMGs who wanted fellowships in IM from a small community hospital in an undesirable city achieve what they wanted. Cards, Immuno, Rheum. Probably difficult for them moreso due to the lack of big names recommending them and doing research with them than the fact that they were not of American heritage. And I agree, the language thing was huge in the hospital where I did my clerkships--patients disliked the FMGs because of a communication barrier. Good luck!

 

[ArrogantSurgeon]

I've noticed a particular trend among IMGs in U.S. residencies...many of them have unbelievable USMLE 1 and 2 scores. I'm talking 240 and above. And most of these guys and gals who destroyed the USMLE don't speak English particularly well.

 

[harshanl]

Thank you all the commentary guys (and gals). It's provided a fascinating insight into prevailing attitudes amongst US physicians towards their FMG colleagues.

I think the US gets a lot of bad rap for giving FMG's a hard time, but it is probably the most egalitarian medical community in the world with regard to giving outsiders a fair chance. I know things are a lot harder in other 1st world countries (e.g. Australia, UK, Canada etc).At the end of the day, if you have a solid knowledge base, great clinical skills and are prepared to work hard, you will most probably get your just desserts.

Successful FMG's seem to have amazing board scores, a great work ethic and good language/interpersonal skills in common. Coming to the US from an Oxbridge education, I'll hopefully have most of these attributes.

Thank you all.
Harshan

 

[Santiago]

Originally posted by ArrogantSurgeon
I've noticed a particular trend among IMGs in U.S. residencies...many of them have unbelievable USMLE 1 and 2 scores. I'm talking 240 and above. And most of these guys and gals who destroyed the USMLE don't speak English particularly well.

It's simple.The more time you spend in your preparation the higher you will score.I should know coz I am an IMG.IMG's spend double the time AMG's take to prepare for the exam.Acc to me it's probably the most important reason.

Regarding the English part,ideally the TOEFL should have taken care of it,but the exam is way too easy.If one isnt careful,one might start snoozing midway between the exams.It's that dumb.

 

[BellKicker]

Y'all need to open your eyes a little bit. The US system, by comparison to other systems, is very EASY to break into.

I'm not saying IMGs have it as easy as the locals in the US but try breaking into systems in, oh say, Europe. Try studying for impossible language tests for years while being caught in dead-end house-officer jobs.

You know how there's the USMLEs, the CSA, the TOEFL for us foreign folks to take? Well, no one here in Scandinavia can tell you which tests to take if you wanna move here! I've tried finding out for a bunch of people from SDN and lemme tell you it's impossible. It doesn't say anywhere.

Think about it. People can go to schools in the Caribbean and go on to awesome careers in the US. I've never, never ever heard of anyone doing that here. If you don't get in the first time, you apply again the following year, and the year after that.

Also, I wonder how many rich countries have a system where foreigners can rather easily get visas if they find a residency.

Ok, so I'm using the thick crayons here but I hope you all see my point.